NM_005247.2:c.351del is a frameshift variant in exon 3 of 3 of FGF3 predicted to produce a truncated protein p.(Phe117LeufsTer41) with loss of the C-terminal 83 amino acids. PVS1 is applied at moderate strength under the ClinGen SVI framework (PMC6185798), downgraded from full strength due to location in the last exon with predicted NMD escape.¹ This variant is absent from all population databases including gnomAD v2.1, v4.1, and gnomAD-Canada (allele frequency 0.00%), meeting PM2 at moderate strength.² The variant is absent from ClinVar and has not been reported in the literature or somatic cancer databases (COSMIC). No functional studies, de novo observations, case-control data, or cosegregation evidence are available.³ With two moderate pathogenic criteria (PVS1_Moderate, PM2_Moderate) and no benign criteria met, the evidence does not reach the threshold for Likely Pathogenic under generic ACMG/AMP 2015 rules (requires three moderate or two moderate plus two supporting criteria). This variant is classified as a Variant of Uncertain Significance (VUS). Additional evidence from functional studies, clinical observations, or family segregation data would be required to reclassify this variant.⁴